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Quality of survival after severe birth asphyxia
Insights
Most children surviving severe birth asphyxia (Apgar score < 4 at 5 minutes) show normal neurological and psychological development. This suggests a positive approach to neonatal resuscitation is warranted for improved outcomes.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Developmental Psychology
Background:
- Severe birth asphyxia is a critical condition in newborns.
- Apgar scores are used to assess newborn health immediately after birth.
- Long-term outcomes for infants experiencing severe birth asphyxia require further investigation.
Purpose of the Study:
- To assess the long-term neurological and psychological development of children who survived severe birth asphyxia.
- To compare the progress of asphyxiated children with a matched control group.
- To evaluate the effectiveness of neonatal resuscitation strategies.
Main Methods:
- A cohort of 31 children with severe birth asphyxia (1-minute Apgar 0 or 5-minute Apgar < 4) was assessed at 5-10 years of age.
- Neurological and psychological assessments were performed.
- The cohort was compared to a control group matched for sex, birthweight, gestational age, and social class.
Main Results:
- 93% of the asphyxiated group and all controls showed no serious neurological or mental handicap.
- Two children in the asphyxiated group were severely disabled and mentally retarded.
- No significant differences in psychological function were found between the groups.
- Two apparently stillborn infants made normal progress.
Conclusions:
- The majority of survivors of severe birth asphyxia experience good quality of life with normal development.
- Identifying perinatal factors that predict severe handicap remains challenging.
- A positive approach to the resuscitation of severely asphyxiated neonates is supported by these findings.
Abstract:
Thirty-one children who survived severe birth asphyxia defined by a 1-minute Apgar score of 0, or a 5-minute Apgar score of less than 4, have been seen at age 5 to 10 years for neurological and psychological assessment. Their progress has been compared with that of controls matched for sex, birthweight, gestational age, and social class. 29(93%) of the 31 asphyxiated group and all the controls had no serious neurological or mental handicap. 2 were severely disabled and mentally retarded. Detailed studies of psychological function showed no significant differences between the two groups. 2 apparently stillborn infants have made normal progress. It was not possible to identify any perinatal factor which predicted the occurrence of serious handicap with certainty. We considered that the quality of life enjoyed by the large majority of the survivors was such as to justify a positive approach to the resuscitation of very severely asphyxiated neonates.